Biology Reference
In-Depth Information
net was developed. The desired effect was the same as IRS, killing female
Anophelines
as they attempted to bite humans inside their houses. Vivax
malaria was, to some extent, ignored in the testing of bed nets as the key
indicator was reduction of malaria mortality (which has historically been
mistakenly not associated with P. vivax). That control of vivax malaria would
follow from methods proven to work for falciparum malaria was assumed
but not extensively documented by field studies (
Luxemburger et al., 1994
;
Rowland et al., 1996
;
Sutanto et al., 1999
). Such field studies are very diffi-
cult for the same reason that eliminating vivax is difficult, the ability of vivax
malaria to reappear for years after transmission ends. Following the eventual
realization that malaria control could not simply be another program put
upon poorly functioning primary care systems, malaria control became a
means to deliver ITN to endemic populations often in conjunction with
other health interventions such as prenatal care or childhood immunization
(
Over et al., 2004
). Problems previously experienced by the GMEP again
appeared, especially the unsolved issue of how to move from reasonably
good malaria control to elimination of the parasite.
2.3. Example of Solomon Islands
From the beginning of colonial administration in the Solomon Islands,
medical officers noted that 'Malaria is one of the greatest factors in the
heavy death-rate among infants and children' (
Crichlow, 1929
). The arrival
of the US and Japanese Armies in the early 1940s provided huge scope for
the parasite with large populations of previously unexposed persons and
breakdown of the civilian health care system. A malaria survey done by
Black in 1952 showed that malaria was found throughout the Solomon
Islands ranging from holoendemic on Guadalcanal and Savo Islands to much
lower levels on some of the outlying coral islands with largely Polynesian as
opposed to Melanesian populations (
Black, 1952
). The GMEP came late to
the Solomon Islands with trials of DDT spraying in the early 1960s, a pre-
eradication program starting in the mid-1960s and expansion to the entire
country by 1970 (
Avery, 1973
). Considerable success was experienced with
a high degree of control resulting in markedly decreased malariometric
parameters. The notable problem areas were the north coast of Guadalcanal
because of the large transient populations that often cooperated poorly with
the spray teams, Nggela islands where transmission was never interrupted
probably because of large brackish water mosquito breeding sites, and a
transplanted Polynesian population on New Georgia that were left living
in undesirable swamp land. Progress was sufficient for the director of the
